Browsing by Author "Anderson, BO"

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A phased approach to implementing the Breast Imaging Reporting and Data System (BI-RADS) in low-income and middle-income countries
(John Wiley and Sons Inc., 2020) Lam, DL; Entezari, P; Duggan, C; Muyinda, Z; Vasquez, A; Huayanay, J; Anderson, BO; Scheel, JR
Background: Successful breast cancer detection programs rely on standardized reporting and interpreting systems, such as the Breast Imaging Reporting and Data System (BI-RADS), to improve system performance. In low-income and middle-income countries, evolving diagnostic programs have insufficient resources to either fully implement BI-RADS or to periodically evaluate the program's performance, which is a necessary component of BI-RADS. This leads to inconsistent breast ultrasound interpretation and a failure to improve performance. Methods: The authors applied the Breast Health Global Initiative's phased implementation strategy to implement diagnostic ultrasound and BI-RADS within the context of a limited-resource setting. Results: The authors recommended starting with triage ultrasound to distinguish suspicious masses from normal breast tissue and benign masses such as cysts because the majority of health workers performing ultrasounds at this level have minimal breast imaging experience. Transitioning to full diagnostic ultrasound with condensed or full BI-RADS should occur after performance and quality metrics have been met. Conclusions: Transitioning through these phases across facilities likely will occur at different times, particularly in rural versus urban settings.
Breast cancer early detection: A phased approach to implementation
(John Wiley and Sons Inc., 2020) Ginsburg, O; Yip, CH; Brooks, A; Cabanes ACaleffi, M; Dunstan Yataco, JA; Gyawali, B; McCormack, V; McLaughlin de Anderson, M; Mehrotra, R; Mohar, A; Murillo, R; Pace, LE; Paskett, ED; Romanoff, A; Rositch, AF; Scheel, JR; Schneidman, M; Unger-Saldaña, K; Vanderpuye, V; Wu, TY; Yuma, S; Dvaladze, A; Duggan, C; Anderson, BO
When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered.